Archived: Hounslow and Ealing

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had promoted a learning culture. Managers and staff investigated and discussed things that had gone wrong. Improvements were made to the service because of these. People and their relatives told us they were informed and had contributed their views when things went wrong. The provider had a clear procedure for responding to incidents, accidents and complaints. Staff were aware of this. The provider held regular staff meetings and provided written information regarding lessons learnt. They shared learning from other branches and examples from other organisations. The registered manager told us that following all adverse events, they carried out a review to ensure people and their relatives were happy with the outcome. Records confirmed this and showed that following investigations, changes had been made to the service and people had been asked to feedback about their experiences directly after this and after the changes had been embedded.

The provider had systems to ensure safe transitions and pathways. They carried out thorough assessments of people’s needs. They liaised with other professionals when needed to review and plan for people’s care. They had liaised with hospices and hospitals when people had been admitted to these. The provider had developed communication profiles and easy to access information sheets about people’s needs which could be shared with other professionals to help them understand how to support each person.

The provider had systems designed to keep people safe from harm. These included procedures for responding to abuse and whistle blowing. People using the service and their relatives told us they felt safe. Their comments included, “My relative is safe with the carers and I trust them”, “We know [person] is safe and very content” and “[Person] is never worried or frightened with the carers. [They are] safe.” Staff undertook training to understand how to recognise and report abuse. They were able to explain the procedures on how to keep people safe from the risk of abuse. The provider had responded to, investigated and made changes because of safeguarding concerns. They had used the learning from these incidents to make sure their procedures and practice were robust. The registered manager told us that safeguarding was discussed in all meetings with staff, including their individual meetings. This helped to make sure staff had a good awareness about best practice.

The provider assessed and planned for the risks to people’s safety and wellbeing. These assessments included considering people’s healthcare and mobility needs. The registered manager told us they had worked with positive behaviour specialists to help plan for the risks of people becoming anxious or agitated. They liaised with people and their relatives to make sure risk assessments were appropriate and that plans to manage risk were the least restrictive and reflected how people wanted to be cared for. Risk assessments were regularly reviewed and updated.

The provider ensured people lived in environments which were safe for them and staff. They assessed the environment and equipment used. When they identified risk, they had liaised with other professionals and people’s relatives to help develop plans to mitigate these. For example, making referrals to specialist teams for extra equipment and highlighting potential hazards.

The provider employed enough staff to meet people’s needs and keep them safe. Each person was assigned a team of regular care workers. People and their relatives told us they knew staff well and had good relationships with them. They told us care workers arrived on time and had the skills needed to provide care. Their comments included, “There is always a replacement carer if needed. If the carers are running late, they do tell us”, “[Care workers] are skilled and well trained and they are on time”, “I think they are trained and skilled” and “They always contact me if they are running late.”

The provider had systems to help make sure staff were suitable to provide care when they recruited them. They carried out a range of checks and staff completed a thorough induction and training. The management team continued to assess staff skills and knowledge throughout their induction and at regular intervals afterwards. They held individual meetings and appraisals of staff skills.

The provider had procedures to prevent and control infection. They ensured staff were well trained in these. They carried out assessments of staff skills and competencies. The provider ensured staff had good supplies of personal protective equipment (PPE). Staff confirmed this. People using the service and their relatives were happy with the way staff presented themselves and the cleanliness of their work. Their comments included, “They clean everything and wear face masks”, “The always do the washing up and they wear gloves and aprons”, “There is PPE left at the home and the agency delivers replacements” and “The carers respect my home, and it is always clean and tidy.”

The provider ensured people received their medicines safely and as prescribed. Staff undertook training to understand safe medicines management. The provider tested their skills and competencies. They also observed them supporting people to take their medicines. There were detailed medicines records, risks assessments and information about the different medicines people were prescribed. Staff completed records to show how and when they had supported people with their medicines. These were checked and audited by the management team. The provider asked people and their families to give regular feedback about how they felt medicines were managed. People told us they were happy with this aspect of their care. People were supported to manage their own medicines when they were able to and wanted this. Risks relating to this were assessed and planned for.